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Baerveldt aqueous shunt implant; Baerveldt glaucoma implant tube

Indications: - patients with refractory glaucoma with current maximally tolerated medical therapy - failure of trabeculectomy [6] - glaucoma with high risk of treatment failure [7] Procedure: - a scleral tunnel is created with a 24-gauge catheter needle - the catheter is used for guidance when introducing a Baerveldt glaucoma implant tube Clinical significance: - at 5 years, intraocular pressure was 13 +/- 5 mm Hg with Baerveldt implants [8] - trabeculectomy with mitomycin C & 350 mm2 Baerveldt glaucoma implant tube shunt with similar intraocular pressure after 5 years of follow-up - fewer glaucoma medications were required after trabeculectomy Complications: - hypotony - 5 year cumulative probability of failure after tube shunt surgery is 38% [9]; 30% [10]

General

orbital implant

References

  1. Gedde SJ, Schiffman JC, Feuer WJ Treatment outcomes in the Tube Versus Trabeculectomy (TVT) study after five years of follow-up. Am J Ophthalmol. 2012 May;153(5):789-803.e2 PMID: 22245458 PMCID: PMC4460598 Free PMC article Clinical Trial
  2. Gedde SJ, Feuer WJ, Lim KS et al Treatment Outcomes in the Primary Tube Versus Trabeculectomy Study after 5 Years of Follow-up. Ophthalmology. 2022 Dec;129(12):1344-1356. PMID: 35835337 Clinical Trial.
  3. Gedde SJ, Feuer WJ, Lim KS et al Treatment Outcomes in the Primary Tube Versus Trabeculectomy Study after 3 Years of Follow-up. Ophthalmology. 2020 Mar;127(3):333-345. PMID: 31727428 Clinical Trial.
  4. Chen J, Gedde SJ. New developments in tube shunt surgery. Curr Opin Ophthalmol. 2019 Mar;30(2):125-131. PMID: 30562244 Review.
  5. Kusaka M, Kujime Y, Yamakawa M, Akimoto M. Baerveldt tube shunt implantation through a long scleral tunnel. Eur J Ophthalmol. 2019 Jul;29(4):458-463. Epub 2018 Jun 7. PMID: 29877117
  6. El Wardani M, Bergin C, Bradly K, Sharkawi E. Baerveldt shunt surgery versus combined Baerveldt shunt and phacoemulsification: a prospective comparative study. Br J Ophthalmol. 2018 Sep;102(9):1248-1253. PMID: 29246892
  7. Pimentel E, Schmidt J. Is Ahmed valve superior to Baerveldt implant as an aqueous shunt for the treatment of glaucoma? Medwave. 2018 Sep 7;18(5):e7239. PMID: 30240388 Review. English, Spanish.
  8. Christakis PG, Zhang D, Budenz DL et al Five-Year Pooled Data Analysis of the Ahmed Baerveldt Comparison Study and the Ahmed Versus Baerveldt Study. Am J Ophthalmol. 2017 Apr;176:118-126. PMID: 28104418 Clinical Trial.
  9. Bowden EC, Choudhury A, Gedde SJ et al Risk Factors for Failure of Tube Shunt Surgery: A Pooled Data Analysis. Am J Ophthalmol. 2022 Aug;240:217-224. PMID: 35288073 PMCID: PMC9614408 Free PMC article. Clinical Trial.
  10. Stein JD, Khawaja AP, Weizer JS Glaucoma in Adults - Screening, Diagnosis, and ManagementA Review. JAMA. 2021;325(2):164-174. Jan 12 PMID: 33433580 https://jamanetwork.com/journals/jama/fullarticle/2774838